Hidden dense middle cerebral artery sign in a 4-year-old boy with traumatic subarachnoid hemorrhage

Bum Joon Kim, Jong Il Choi, Sung Kon Ha, Dong Jun Lim, Sang Dae Kim

Research output: Contribution to journalArticlepeer-review


A 4-year-old boy was admitted with acute onset of hemiplegia of the right side that was secondary to a traffic accident. Initial computed tomography revealed a traumatic subarachnoid hemorrhage, and follow-up computed tomography showed a more localized hematoma of the left sylvian cistern. After a few days of conservative treatment, magnetic resonance imaging (MRI) revealed a cerebral infarction of the left lenticulostriate territory, even though magnetic resonance angiography showed preserved middle cerebral artery flow. Thus, we realized that the hematoma of the sylvian cistern was the so-called dense middle cerebral artery sign. This case of posttraumatic infarction suggested the importance of meticulous investigations and clinical correlations of imaging studies in pediatric patients with head injuries.

Original languageEnglish
Pages (from-to)NP189-NP192
JournalJournal of Child Neurology
Issue number12
Publication statusPublished - 2014 Dec

Bibliographical note

Publisher Copyright:
© The Author(s) 2013.

Copyright 2021 Elsevier B.V., All rights reserved.


  • Dense middle cerebral artery sign
  • Lenticulostriate infarct
  • Posttraumatic infarction
  • Striatocapsular infarct
  • Traumatic subarachnoid hemorrhage

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology


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